Jendu Application

Dear prospective owner: Thank you for considering Jendu Wheaten Terriers. Please complete this application if you are serious about adding a Wheaten Terrier to your home. By filling out this application it is not a guarantee of a puppy. We will carefully review your application and be in touch with you.

Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Home/Cell Phone

Email

What is your age?

Your place of employment

Work Phone

Spouse or Partner's Name

First

Last

Spouse or Partner Phone

Are you able and willing to visit Jendu Wheatens In Dayton Ohio

Describe

Own
Rent
Live With Parents
Other

Do you have a landlord/association that allows dogs?

Yes
No
n/a

Name of Landlord or Association

Phone of Landlord or Association

How long, in years have you lived at this address?

Do you have a pool?

Yes
No

Do you have a fenced in yard?

Yes
No

How many adults live in the household?

Are there children living in this household?

Yes
No

Is anyone in the household special needs

Yes
No

Are all the members of your household in agreement about adopting a Soft Coated Wheaten Terrier?

Yes
No

Is anyone in the household nervous or unsure around dogs?

Yes
No

Who will be the primary caregiver of the dog?

Are you willing to have all the members of your household come to our home to meet us and our dogs?

Yes
No
Unsure

Do any members of your household have asthma, or have allergies to dogs?

Yes
No

How often do you travel?

Why did you choose a Soft Coated Wheaten Terrier?

Do you have another dog(s) in the house?

Yes
No

Do you have cat(s) in the house?

Yes
No

Have all your family members been around dogs?

Yes
No

Have you had the experience of being the primary caregiver to a dog?

Yes
No

Have you ever given a pet away, given it to a shelter or rescue group, returned it to a breeder or sold it?

Yes
No

Have you ever had a pet for a short period of time and it didn't work out?

Yes
No

Have you ever had an animal lost or stolen?

Yes
No

Have you ever had to receive your animal from a pound, shelter or animal control facility?

Yes
No

of Does planning

Have you ever had an animal die as the result of being hit by a car, being poisoned or from unknown causes?

Yes
No

Have you had a dog that gave birth?

Yes
No

Have you ever owned a Soft Coated Wheaten Terrier?

Yes
No

Tell us about your Wheaten Terrier, where did you purchase it from? Name? Tell us about the dog?

First Reference Name

First

Last

Relationship reference #1

Phone

Second Reference Name

First

Last

Relationship reference #2

Second reference Phone

Third Reference Name

First

Last

Relationship reference #3

Reference #3 Phone

What veterinary practice do you plan to use? State name and Phone.

Are you willing able to ensure your puppy/dog visit a veterinarian for yearly exams, and for vaccinations?

Yes
No

Will you have your puppy spayed or neutered at six months of age?

Yes
No

Are you planning to crate train your puppy?

Yes
No

Are you aware that house training can take up to 6 months or more?

Yes
No

Will you have your puppy/dog groomed at least once a month?

Yes
No

Do you plan to walk or run with your puppy/dog?

Yes
No

How many hours would the puppy/dog be alone during the day?

In the event of an emergency, who would care for your dog or what arrangements would you make?

Date you would be able to retrieve your puppy/dog.

Signature

Clear Signature

By signing the below, I certify that: The information I have given is accurate. I understand that Jendu Wheatens has the right to deny any application. I give permission for Jendu Wheatens to call the references and veterinary practices I have listed. I understand that a visit to Jendu wheatens is required of final placement or sale.